| Facility failed to meet the following Requirement(s): | Corrected Date | Level of Harm | Residents Affected |
| The administrator/manager shall develop and implement a safe and effective system of medication control and use, which assures that all residents ' medications are administered by personnel at least eighteen (18) years of age, in accordance with physicians ' instructions using acceptable nursing techniques. The facility shall employ a licensed nurse eight (8) hours per week for every thirty (30) residents to monitor each resident ' s condition and medication. Administration of medication shall mean delivering to a resident his or her prescription medication either in the original pharmacy container, or for internal medication, removing an individual dose from the pharmacy container and placing it in a small container or liquid medium for the resident to remove from the container and self-administer. External prescription medication may be applied by facility personnel if the resident is unable to do so and the resident ' s physician so authorizes. All individuals who administer medication shall be trained in medication administration and, if not a physician or a licensed nurse, shall be a certified medication technician or level I medication aide. I/II
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1/23/2020
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| At least every three (3) months in a residential care facility, a pharmacist or registered nurse shall review the controlled substance record keeping including reconciling the inventories of controlled substances. This shall be done at the time of the drug regimen review of each resident. All discrepancies in controlled substance records shall be reported to the administrator or manager for review and investigation. The theft or loss of controlled substances shall be reported as follows: II/III
(A) The facility shall notify the department ' s Section for Long Term Care (SLTC) and other appropriate authorities of any theft or significant loss of any controlled substance medication written as an individual prescription for a specific resident upon the discovery of the theft or loss. The facility shall consider at least the following factors in determining if a loss is significant:
1. The actual quantity lost in relation to the total quantity;
2. The specific controlled substance lost;
3. Whether the loss can be associated with access by specific individuals;
4. Whether there is a pattern of losses, and if the losses appear to be random or not;
5. Whether the controlled substance is a likely candidate for diversion; and
6. Local trends and other indicators of diversion potential; II/III
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1/23/2020
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Missouri Department of Health & Senior Services